Pregnancy can sometimes wreak havoc on your body image. Here's how to embrace your new shape and learn to love yourself for these 9 months and beyond.
If you're not loving your voluptuous new self, you're not alone: Pregnancy, although usually a joyful time, can still negatively affect the way you feel about your body. Take Mary Kay Mangiarelli, a mother of two in Aurora, Ill. "I was overweight when I got pregnant," she recalls. "So I had the weight I started with, plus the bad feelings about that, plus the new pregnancy weight—and it all compounded." While she was thrilled to be expecting, pregnancy didn't erase her poor self-image—in fact, she actually began to feel worse about it.
Related: Learn to Love Your Pregnancy Body
It's not all in your head
It makes sense that pregnancy's drastic physical changes can produce shifts in self-esteem and body image. "All women undergo enormous physiological changes during pregnancy and childbirth," explains Rebecca Anne Turner, Ph.D., professor of clinical psychology at the California School of Professional Psychology in San Francisco. "Nevertheless, two people may react very differently to the same set of hormonal changes." Glass-half-empty types may not embrace physical shifts as readily as their more optimistic friends. The self-image you held going into pregnancy, particularly in regard to weight, may also complicate your feelings. Women with a history of eating disorders or obesity face particular challenges, although the prospect of gaining 30 or so pounds in less than a year can be daunting for anyone.
Medical and mental-health experts concur that when it comes to body image and pregnancy, we're all influenced by common factors. First, there's the undeniable fact that pregnancy changes everything—literally. "Changes occur not only in the body but also in the brain," Turner notes. "There's a proliferation of new receptors, such as those for estrogen, oxytocin and prolactin, which prepare the woman and her body for childbirth, breastfeeding and nurturing. In addition, neuron growth essentially 'rewires' the brain for motherhood." These dramatic chemical shifts can take you on an emotional roller coaster. Body image also hinges to some degree on messages, direct or indirect, you receive from people around you. Heather Maynard, a former teacher living in West Hartford, Conn., is 4 feet 11 inches tall. When she was nine months pregnant, a tactless co-worker commented in the faculty room, "Heather's as wide as she is tall—just like a Weeble!" As Maynard recalls, "Up until then, I hadn't thought I looked that bad. Suddenly, I felt very conspicuous." Larger societal views of pregnancy can color your body image, too. For instance, the media were quick to praise the pregnant actress Sarah Jessica Parker, who maintained her shapely legs and touted a fashionable "bump," but mocked actress Kate Hudson who gained a less-stylish 60 pounds during her pregnancy.
As her weight increased, Mangiarelli didn't know which pounds were pregnancy-related and which were just the result of bad habits. "I knew my body was supposed to do different things, but since it was my first pregnancy, I didn't know what, exactly," she says. (Visit www.fitpregnancy.com/40weeks to learn more about the physical and emotional changes that occur each trimester.)
Find a community
Freeing yourself from a negative body image—and making a good one last beyond pregnancy—is a matter of establishing connections, both with yourself and others. You can do that by surfing the web for information and forums, examining what's really important (your baby's health or your desire to be thin) and seeking the help of a therapist, which is especially helpful if you have a history of anorexia or bulimia (see "Pregnancy and Eating Disorders," below). Andrea Mechanick Braverman, Ph.D., director of psychological and complementary medicine at Reproductive Medicine Associates in Morristown, N.J., strongly advises seeking out other pregnant women. "There's nothing like finding someone else who feels dumpy at the beginning of her second trimester," she says, adding that feelings of isolation can make matters worse. Take a birthing class or like the Fit Pregnancy Facebook page to connect with fellow moms-to-be. Realign your priorities
If you normally take your daily workouts and clean eating seriously, you may be able to continue your regimen (with modifications), although this is not the time to diet. In fact, low prepregnancy weight and inadequate pregnancy weight gain have been associated with problems such as low-birth-weight infants, prematurity and delivery complications. In general, if you were at a healthy weight when you conceived, you should gain 25 to 35 pounds. Underweight women should gain 28 to 40 pounds, and overweight ones should aim for 15 to 25 pounds.
"If thinness was how you used to measure self-worth, try to find other ways for these nine months," suggests Marianne Tebbens, M.S., L.P.C., a Philadelphia-based psychotherapist with 20 years of experience in treating eating disorders. Revisit a neglected hobby or volunteer to raise funds or stuff envelopes for a local charity. You might discover that you come to rely on these new yardsticks of validation after giving birth, too.
"We tend to associate therapy with having a really big problem," Braverman says. "But if you're struggling with body image, it may only take a few sessions to find out where these negative messages are coming from." Once identified, they're more easily handled—especially with a therapist's help. Your obstetrician or midwife will most likely be able to recommend a therapist.
Certainly, if you're feeling great about your pregnant body, enjoy these nine months. If you see yourself as less than stunning, however, keep in mind that even if each day seems to drag, pregnancy does have a 40-week (or so) deadline. If you focus on nutrition rather than dieting, the result—a healthy baby—will be even more enviable than thin thighs.
Pregnancy and eating disorders
Research shows that many women with eating disorders stop their destructive behavior during pregnancy—some quite easily. However, "women with a history of anorexia, bulimia, compulsive exercise or other eating disorders should recognize that pregnancy can be a tremendous stressor, bringing up anxiety issues around food and the body," notes Margo Maine, Ph.D., author of The Body Myth: Adult Women and the Pressure to Be Perfect. The good news? You can overcome such hurdles.
Share your history Be honest with your care provider so that she can monitor your weight gain more carefully. Some doctors will offer early ultrasounds so you can see the living results of your healthy eating.
Prepare for rapid gains Women with a history of restrictive eating may gain weight quickly at the beginning of their pregnancy. "This is normal," Maine says. "Your metabolic rate will be lower, and since the body knows it needs to gain weight, it will do so sooner." Then your weight gain should slow down.
Dig deeper "Like other psychiatric illnesses, eating disorders often have depression, anxiety or self-esteem problems underneath," says psychotherapist Marianne Tebbens, M.S., L.P.C. If you find your disorder lingers, a therapist can help you work on these root causes.
Get help If you can't control your eating disorder, don't go it alone. "It's critical to get help from professionals with experience in treating eating disorders, including a registered dietitian who can ensure that your food intake is sufficient to support a viable pregnancy," Maine advises. Ask your medical provider to recommend a specialist who can assess the level of care you need, whether it's outpatient services or hospitalization. Maine suggests the National Eating Disorders Association and www.bulimia.com as additional resources for referrals and books.